tbuckley/cabot-search huggingface dataset:
Vasovagal Responses to Human Monomorphic Ventricular Tachycardia
Authors: Margarida Pujol-Lopez, Jeanne Du Fay de Lavallaz, Pooja Rangan, Andrew Beaser, Zaid Aziz, Gaurav A. Upadhyay, Hemal Nayak, J. Peter Weiss, Michael Zawaneh, Rong Bai, Wilber Su, Roderick Tung
Journal: Journal of the American College of Cardiology (2023)
Ventricular Arrhythmias in Adults With Congenital Heart Disease, Part I
Authors: Francis Bessière, Victor Waldmann, Nicolas Combes, Olivier Metton, Nabil Dib, Blandine Mondésert, Edward O’Leary, Elizabeth De Witt, Chrystalle Katte Carreon, Stephen P. Sanders, Jeremy P. Moore, John Triedman, Paul Khairy
Journal: Journal of the American College of Cardiology (2023)
Long-Term Outcome and Prognosis of Noninfectious Thoracic Aortitis
Authors: Olivier Espitia, Patrick Bruneval, Morgane Assaraf, Jacques Pouchot, Eric Liozon, Hubert de Boysson, Julien Gaudric, Laurent Chiche, Paul Achouh, Jean-Christian Roussel, Sébastien Miranda, Tristan Mirault, Samia Boussouar, Alban Redheuil, Jean-Michel Serfaty, Antoine Bénichou, Christian Agard, Alexis F. Guédon, Patrice Cacoub, François Paraf, Pierre-Jean Fouret, Claire Toquet, Lucie Biard, David Saadoun
Journal: Journal of the American College of Cardiology (2023)
Clinical and immunological characteristics of prolonged SARS-CoV-2 Omicron infection in hematologic disease
Authors: Daisuke Ikeda, Ami Fukumoto, Yuka Uesugi, Rikako Tabata, Daisuke Miura, Kentaro Narita, Masami Takeuchi, Tomohisa Watari, Yoshihito Otsuka, Kosei Matsue
Journal: Blood Cancer Journal (2023)
Health-care systems' resource footprints and their access and quality in 49 regions between 1995 and 2015: an input–output analysis
Authors: Baptiste Andrieu, Laurie Marrauld, Olivier Vidal, Mathis Egnell, Laurent Boyer, Guillaume Fond
Journal: The Lancet Planetary Health (2023)

BackgroundStrategies to reduce the environmental impact of health care are often limited to greenhouse gas emissions. To broaden their scope, our aim was to determine the evolution of the resource footprints, dependency, and efficiency of health-care systems and to determine the relationship between this evolution and their Healthcare Access and Quality (HAQ) index.MethodsWe carried out an input–output analysis of 49 health-care systems from 1995 to 2015. We harmonised the EXIOBASE v3.8.2 database—providing data for 49 world regions—to the World Health Organization Health Expenditures Database. We then performed a panel data analysis to understand the relationship between Healthcare Access and Quality index and energy footprint per capita of health-care systems. EXIOBASE3 does not provide measurement errors so it was not possible to propagate the uncertainties as can be done with other input–output databases.FindingsHealth-care systems' footprint increased over the past two decades, reaching 7% of global non-metallic minerals footprint, 4% of global metal ores footprint, and 5% of global fossil fuels footprint in 2013. This increase was mostly due to China, rising from 7% of the non-metallic minerals footprint in 1995 to 45% in 2013. 80% of the health-care systems studied were dependent at more than 50% on fossil fuel imports. The energy footprint per capita was correlated exponentially with the HAQ index but some countries performed much better than others at a given energy footprint. Health-care systems have not become more efficient between 2002 and 2015.InterpretationHealth-care systems' resources footprint are exponentially linked to their HAQ. Both prevention and efficiency measures will be needed to change this relationship. If it is not enough, high-income countries will have to choose between further reducing the resource consumption of their health-care systems or shifting the efforts to other sectors, health being considered an incompressible need. We call for the creation of a HAQE (health-care access, quality, and efficiency) index that would add resource efficiency to access and quality when ranking health-care systems.FundingThe Shift Project.
Comparative Effectiveness of Biologic Therapies in Preventing Penetrating Complications in Patients With Crohn’s Disease
Authors: Jeffrey D. McCurdy, Dustin Stwalley, Margaret A. Olsen, Parakkal Deepak
Journal: Clinical Gastroenterology and Hepatology (2023)

Comparative effectiveness of biologics in preventing penetrating disease (PD) in Crohn's disease (CD) is not well established. We compared the risk of developing luminal and perianal PD (LPD and PPD) between biologics used as first-line therapies.
Phenylboronic Acid‐Modified Near‐Infrared Region II Excitation Donor–Acceptor–Donor Molecule for 2‐Deoxy‐<scp>d</scp>‐Glucose Improved Starvation/Chemo/Photothermal Combination Therapy
Authors: Pengfei Sun, Wan Yang, Jiarong He, Liuliang He, Pengfei Chen, Wenjuan Xu, Qingming Shen, Daifeng Li, Quli Fan
Journal: Advanced Healthcare Materials (2023)

Abstract Synergistic chemotherapy and photothermal therapy (PTT) have emerged as a promising anticancer paradigm to achieve expected therapeutic effects while mitigating side effects. However, the chemo/PTT combination therapy suffers from limited penetration depth, thermoresistance performance of tumor cells, and low drug bioavailability. Herein, multifunctional nanoparticles (BTP/DOX/2DG NPs) coloaded with near‐infrared region II (NIR‐II) light excitation donor–acceptor–donor (D–A–D) small molecules, doxorubicin (DOX), and 2‐deoxy‐ d ‐glucose (2‐DG) are developed for reinforced starvation/chemo/NIR‐II PTT combination therapy. The synthesized phenylboronic acid (PBA)‐modified water‐soluble D–A–D molecule (BBT‐TF‐PBA) not only exhibits high binding ability to DOX and 2‐DG through donor–acceptor coordination interactions PBA–diol bonds but also serves as a photoactive agent for NIR‐II fluorescence imaging, NIR‐II photoacoustic imaging, and NIR‐II PTT. Under the acidic and oxidizing conditions in the tumor microenvironment, donor–acceptor coordination interactions and PBA–diol bond are decomposed, simultaneously releasing DOX and 2‐DG from BTP/DOX/2DG NPs to achieve effective chemotherapy and starvation therapy. 2‐DG also effectively inhibits the expression of heat shock protein and further enhances NIR‐II PTT and chemotherapy efficiency. In vitro and in vivo experiments demonstrate the combination effect of BTP/DOX/2DG NPs for chemotherapy, NIR‐II PTT, and starvation therapy.
In treatment-resistant major depression, ketamine was noninferior to ECT for treatment response
Authors: Tracey Holsinger, Paul Riordan
Journal: Annals of Internal Medicine (2023)

Anand A, Mathew SJ, Sanacora G, et al. Ketamine versus ECT for nonpsychotic treatment-resistant major depression. N Engl J Med. 2023;388:2315-2325. 37224232.
Standards and Ethics Issues in the Determination of Death: A Position Paper From the American College of Physicians
Authors: Matthew DeCamp, Kenneth Prager, Isaac O. Opole, Noel N. Deep, T. Brian Callister, George M. Abraham, Sue S. Bornstein, Eduardo Bruera, Joel Burnett, Jan K. Carney, Angelique N. Collamer, Thomas G. Cooney, Kari L. Esbensen, Joseph J. Fins, Olivia I. Fuson, Taylor Harp, Amy K. Holbrook, Thomas S. Huddle, Diana Jung, Mark A. Levine, Ryan D. Mire, Kenneth M. Prager, Erik A. Wallace
Journal: Annals of Internal Medicine (2023)

The determination of a patient's death is of considerable medical and ethical significance. Death is a biological concept with social implications. Acting with honesty, transparency, respect, and integrity is critical to trust in the patient-physician relationship, and the profession, in life and in death. Over time, cases about the determination of death have raised questions that need to be addressed. This American College of Physicians position paper addresses current controversies and supports a clarification to the Uniform Determination of Death Act; maintaining the 2 current independent standards of determining death, cardiorespiratory and neurologic; retaining the whole brain death standard; aligning medical testing with the standards; keeping issues about the determination of death separate from organ transplantation; reaffirming the importance and role of the dead donor rule; and engaging in educational efforts for health professionals, patients, and the public on these issues. Physicians should advocate for policies and practices on the determination of death that are consistent with the profession's fundamental and timeless commitment to individual patients and the public.
In HF, with or without PAD, dapagliflozin reduced a composite of worsening HF or CV death and did not increase amputations
Authors: Debabrata Mukherjee
Journal: Annals of Internal Medicine (2023)

Butt JH, Kondo T, Yang M, et al. Heart failure, peripheral artery disease, and dapagliflozin: a patient-level meta-analysis of DAPA-HF and DELIVER. Eur Heart J. 2023;44:2170-2183. 37220172.
In moderate-to-severe Crohn disease, upadacitinib increased clinical remission at 12 and 52 wk
Authors: Catherine Rowan
Journal: Annals of Internal Medicine (2023)

ACP Journal ClubSeptember 2023In moderate-to-severe Crohn disease, upadacitinib increased clinical remission at 12 and 52 wkCatherine Rowan, MB BCH BAO, MDCatherine Rowan, MB BCH BAO, MDUniversity of Calgary, Calgary, Alberta, Canada (C.R.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/J23-0069 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationLoftus EV Jr, Panés J, Lacerda AP, et al. Upadacitinib induction and maintenance therapy for Crohn's disease. N Engl J Med. 2023;388:1966-1980. https://pubmed.ncbi.nlm.nih.gov/37224198Clinical Impact RatingsGIM/FP/GP: Gastroenterology: References1. Danese S, Vermeire S, Zhou W, et al. Upadacitinib as induction and maintenance therapy for moderately to severely active ulcerative colitis: results from three phase 3, multicentre, double-blind, randomised trials. Lancet. 2022;399:2113-2128. [PMID: 35644166] Google Scholar2. U.S. Food and Drug Administration. Rinvoq: highlights of prescribing information. Accessed at www.accessdata.fda.gov/drugsatfda_docs/label/2023/211675s015lbl.pdf on 17 Jul 2023. Google Scholar Author, Article, and Disclosure InformationAuthors: Catherine Rowan, MB BCH BAO, MDAffiliations: University of Calgary, Calgary, Alberta, Canada (C.R.)Disclosures: The commentator has reported no disclosures of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=J23-0069.This article was published at Annals.org on 5 September 2023.ACP Journal Club is editorially independent from Annals of Internal Medicine. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics September 2023Volume 176, Issue 9Page: JC103KeywordsBiologicsCrohn's diseaseDrug therapyPatientsQuality of lifeSafetySteroidsThrombosisUlcerative colitis ePublished: 5 September 2023 Issue Published: September 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Comparative Safety Analysis of Oral Antipsychotics for In-Hospital Adverse Clinical Events in Older Adults After Major Surgery
Authors: Dae Hyun Kim, Su Been Lee, Chan Mi Park, Raisa Levin, Eran Metzger, Brian T. Bateman, E. Wesley Ely, Pratik P. Pandharipande, Margaret A. Pisani, Richard N. Jones, Edward R. Marcantonio, Sharon K. Inouye
Journal: Annals of Internal Medicine (2023)

Background: Antipsychotics are commonly used to manage postoperative delirium. Recent studies reported that haloperidol use has declined, and atypical antipsychotic use has increased over time. Objective: To compare the risk for in-hospital adverse events associated with oral haloperidol, olanzapine, quetiapine, and risperidone in older patients after major surgery. Design: Retrospective cohort study. Setting: U.S. hospitals in the Premier Healthcare Database. Patients: 17 115 patients aged 65 years and older without psychiatric disorders who were prescribed an oral antipsychotic drug after major surgery from 2009 to 2018. Interventions: Haloperidol (≤4 mg on the day of initiation), olanzapine (≤10 mg), quetiapine (≤150 mg), and risperidone (≤4 mg). Measurements: The risk ratios (RRs) for in-hospital death, cardiac arrhythmia events, pneumonia, and stroke or transient ischemic attack (TIA) were estimated after propensity score overlap weighting. Results: The weighted population had a mean age of 79.6 years, was 60.5% female, and had in-hospital death of 3.1%. Among the 4 antipsychotics, quetiapine was the most prescribed (53.0% of total exposure). There was no statistically significant difference in the risk for in-hospital death among patients treated with haloperidol (3.7%, reference group), olanzapine (2.8%; RR, 0.74 [95% CI, 0.42 to 1.27]), quetiapine (2.6%; RR, 0.70 [CI, 0.47 to 1.04]), and risperidone (3.3%; RR, 0.90 [CI, 0.53 to 1.41]). The risk for nonfatal clinical events ranged from 2.0% to 2.6% for a cardiac arrhythmia event, 4.2% to 4.6% for pneumonia, and 0.6% to 1.2% for stroke or TIA, with no statistically significant differences by treatment group. Limitation: Residual confounding by delirium severity; lack of untreated group; restriction to oral low-to-moderate dose treatment. Conclusion: These results suggest that atypical antipsychotics and haloperidol have similar rates of in-hospital adverse clinical events in older patients with postoperative delirium who receive an oral low-to-moderate dose antipsychotic drug. Primary Funding Source: National Institute on Aging.
In COPD with type 2 inflammation despite inhaled triple therapy, dupilumab safely reduced exacerbations
Authors: Rodolfo A. Estrada, Diego J. Maselli, Antonio R. Anzueto
Journal: Annals of Internal Medicine (2023)

Bhatt SP, Rabe KF, Hanania NA, et al; BOREAS Investigators. Dupilumab for COPD with type 2 inflammation indicated by eosinophil counts. N Engl J Med. 2023;389;205-214.37272521.
In chronic HF, empagliflozin reduced a composite of CV death or HF hospitalization across kidney risk categories
Authors: Ali Ziaolhagh, Donald A. Molony
Journal: Annals of Internal Medicine (2023)

ACP Journal ClubSeptember 2023In chronic HF, empagliflozin reduced a composite of CV death or HF hospitalization across kidney risk categoriesAli Ziaolhagh, MD, Donald A. Molony, MDAli Ziaolhagh, MDUT-McGovern Medical School, Houston, Texas, USA (A.Z., D.A.M.)Search for more papers by this author, Donald A. Molony, MDUT-McGovern Medical School, Houston, Texas, USA (A.Z., D.A.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/J23-0065 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationButler J, Packer M, Siddiqi TJ, et al. Efficacy of empagliflozin in patients with heart failure across kidney risk categories. J Am Coll Cardiol. 2023;81:1902-1914. https://pubmed.ncbi.nlm.nih.gov/37164523Clinical Impact RatingsGIM/FP/GP: Cardiology: Nephrology: References1. Verma S, McGuire DK, Kosiborod MN. Two tales: one story: EMPEROR-Reduced and DAPA-HF. Circulation. 2020;142:2201-2204. [PMID: 32969716] Google Scholar2. Aguilar-Gallardo JS, Correa A, Contreras JP. Cardio-renal benefits of sodium–glucose co-transporter 2 inhibitors in heart failure with reduced ejection fraction: mechanisms and clinical evidence. Eur Heart J Cardiovasc Pharmacother. 2022;8:311-321. [PMID: 34264341] Google Scholar3. Kristensen SL, Jensen J, Schou M. SGLT2 inhibitors in patients with heart failure and chronic kidney disease: jigsaw falling into place [Editorial]. J Am Coll Cardiol. 2023;81:1915-1917. [PMID: 37164524] Google Scholar Author, Article, and Disclosure InformationAuthors: Ali Ziaolhagh, MD; Donald A. Molony, MDAffiliations: UT-McGovern Medical School, Houston, Texas, USA (A.Z., D.A.M.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=J23-0065.This article was published at Annals.org on 5 September 2023.ACP Journal Club is editorially independent from Annals of Internal Medicine. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics September 2023Volume 176, Issue 9Page: JC101KeywordsClinical trialsEstimated glomerular filtration rateHeart failureHospitalizationsKidney functionKidneysLeft ventricular ejection fractionRandomized trialsRenal diseasesRenal failure ePublished: 5 September 2023 Issue Published: September 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
CTFPHC recommends risk assessment–first screening to prevent fragility fractures in women aged ≥65 y
Authors: Kouta Ito
Journal: Annals of Internal Medicine (2023)

Source Citation Thériault G, Limburg H, Klarenbach S, et al; Canadian Task Force on Preventive Health Care. Recommendations on screening for primary prevention of fragility fractures. CMAJ. 2023;195:E639-E649. 37156553
Delivery of biologics: Topical administration
Authors: Rachel J. Kulchar, Rahul Singh, Suwan Ding, Elena Alexander, Kam W. Leong, Henry Daniell
Journal: Biomaterials (2023)

Biologics are unaffordable to a large majority of the global population because of prohibitively expensive fermentation systems, purification and the requirement for cold chain for storage and transportation. Limitations of current production and delivery systems of biologics were evident during the recent pandemic when <2.5% of vaccines produced were available to low-income countries and ∼19 million doses were discarded in Africa due to lack of cold-chain infrastructure. Among FDA-approved biologics since 2015, >90% are delivered using invasive methods. While oral or topical drugs are highly preferred by patients because of their affordability and convenience, only two oral drugs have been approved by FDA since 2015. A newly launched oral biologic costs only ∼3% of the average cost of injectable biologics because of the simplified regulatory approval process by elimination of prohibitively expensive fermentation, purification, cold storage/transportation. In addition, the cost of developing a new biologic injectable product (∼$2.5 billion) has been dramatically reduced through oral or topical delivery. Topical delivery has the unique advantage of targeted delivery of high concentration protein drugs, without getting diluted in circulating blood. However, only very few topical drugs have been approved by the FDA. Therefore, this review highlights recent advances in oral or topical delivery of proteins at early or advanced stages of human clinical trials using chewing gums, patches or sprays, or nucleic acid drugs directly, or in combination with, nanoparticles and offers future directions.
The global community needs to do more to tackle the inequality crisis
Authors: Michael G Marmot, Monica Geingos, Joseph E Stiglitz
Journal: BMJ (2023)

The climate emergency and the global rise in inequalities are putting us all at risk.Both will damage health.The global community, with successive climate change conferences (COPs), is taking faltering steps to tackle the climate emergency but is doing little about the inequality crisis.In some countries, political and economic forces are increasing social and economic inequalities, with potentially dire consequences for health inequalities and for people's vulnerability to pandemics.Unfair distribution of power, money, and resources are driving inequalities in health.
A globally applicable “triple <scp>A</scp>” risk model for essential thrombocythemia based on <scp>A</scp>ge, <scp>A</scp>bsolute neutrophil count, and <scp>A</scp>bsolute lymphocyte count
Authors: Ayalew Tefferi, Giuseppe G. Loscocco, Faiqa Farrukh, Natasha Szuber, Francesco Mannelli, Animesh Pardanani, Curtis A. Hanson, Rhett P. Ketterling, Valerio De Stefano, Alessandra Carobbio, Tiziano Barbui, Paola Guglielmelli, Naseema Gangat, Alessandro M. Vannucchi
Journal: American Journal of Hematology (2023)

We examined the individual prognostic contribution of absolute neutrophil (ANC), lymphocyte (ALC), and monocyte (AMC) counts, on overall (OS), leukemia-free (LFS), and myelofibrosis-free (MFFS) survival in essential thrombocythemia (ET). Informative cases (N = 598; median age 59 years; females 62%) were retrospectively accrued from a Mayo Clinic database: JAK2 59%, CALR 27%, triple-negative 11%, and MPL 3%; international prognostic scoring system for ET (IPSET) risk high 21%, intermediate 42%, and low 37%; 7% (37/515) had abnormal karyotype and 10% (21/205) adverse mutations (SF3B1/SRSF2/U2AF1/TP53). At median 8.4 years, 163 (27%) deaths, 71 (12%) fibrotic, and 20 (3%) leukemic transformations were recorded. Multivariable analysis resulted in HR (95% CI) of 16.5 (9.9-27.4) for age > 70 years, 3.7 (2.3-6.0) for age 50-70 years, 2.4 (1.7-3.3) for ANC ≥8 × 10
Size‐Tunable Nanoregulator‐Based Radiofrequency Ablation Suppresses MDSCs and Their Compensatory Immune Evasion in Hepatocellular Carcinoma
Authors: Yuhao Tang, Zhilin Shu, Meiyan Zhu, Shuping Li, Yunyan Ling, Yizhen Fu, Zili Hu, Jiongliang Wang, Zhenyun Yang, Junbin Liao, Li Xu, Meng Yu, Zhenwei Peng
Journal: Advanced Healthcare Materials (2023)

Radiofrequency ablation (RFA) is a widely used therapy for hepatocellular carcinoma (HCC). However, in cases of insufficient RFA (iRFA), nonlethal temperatures in the transition zone increase the risk of postoperative relapse. The pathological analysis of HCC tissues shows that iRFA-induced upregulation of myeloid-derived suppressor cells (MDSCs) in residual tumors is critical for postoperative recurrence. Furthermore, this study demonstrates, for the first time, that combining MDSCs suppression strategy during iRFA can unexpectedly lead to a compensatory increase in PD-L1 expression on the residual MDSCs, attributed to relapse due to immune evasion. To address this issue, a novel size-tunable hybrid nano-microliposome is designed to co-deliver MDSCs inhibitors (IPI549) and αPDL1 antibodies (LPIP) for multipathway activation of immune responses. The LPIP is triggered to release immune regulators by the mild heat in the transition zone of iRFA, selectively inhibiting MDSCs and blocking the compensatory upregulation of PD-L1 on surviving MDSCs. The combined strategy of LPIP + iRFA effectively ablates the primary tumor by activating immune responses in the transition zone while suppressing the compensatory immune evasion of surviving MDSCs. This approach avoids the relapse of the residual tumor in a post-iRFA incomplete ablation model and appears to be a promising strategy in RFA for the eradication of HCC.
Abnormal gastrointestinal motility is a major factor in explaining symptoms and a potential therapeutic target in patients with disorders of gut–brain interaction
Authors: Michael Camilleri
Journal: Gut (2023)

The objective of this article is to review the evidence of abnormal gastrointestinal (GI) tract motor functions in the context of disorders of gut–brain interaction (DGBI). These include abnormalities of oesophageal motility, gastric emptying, gastric accommodation, colonic transit, colonic motility, colonic volume and rectal evacuation. For each section regarding GI motor dysfunction, the article describes the preferred methods and the documented motor dysfunctions in DGBI based on those methods. The predominantly non-invasive measurements of gut motility as well as therapeutic interventions directed to abnormalities of motility suggest that such measurements are to be considered in patients with DGBI not responding to first-line approaches to behavioural or empirical dietary or pharmacological treatment.